Understanding Medicare Enrollment Periods

By Michele Campbell

It’s that time of year as eligible South County residents can apply for Medicare.

Enrollment Periods are times a person can enroll or change existing Medicare plans. There can be separate enrollment periods for Medicare Parts A and B (Original Medicare) and Medicare Part C (Medicare Advantage).

Enrollment periods include:

Initial Enrollment Period (IEP) – After becoming eligible for Medicare and enrolling into Medicare Parts A and B, you have your Initial Enrollment Period, where you can enroll for the first time an additional Medicare health plan and/or drug plan. This timeline is seven months long and begins three months before the month of a person’s 65th birthday, the birthday month and continues through the three months after a person’s 65th birthday month.  This could also be for someone under 65, who is disabled for 24 months and is newly qualified for Medicare.

Initial Coverage Election Period (ICEP) – the first time a newly eligible person can enroll in a Medicare Advantage plan or if someone is new to Part B and had previous creditable coverage.

General Enrollment Period (GEP) – runs Jan. 1 through March 31 each year and provides an enrollment opportunity for individuals who didn’t sign up for Medicare Part B when they were first eligible. Individuals may have to pay a late enrollment penalty for not enrolling when first eligible and coverage will not start until July 1 of that year.

Annual Enrollment Period for Medicare Advantage and Prescription Drug Plans (AEP) – current Medicare recipients can change or enroll in these plans during this period that runs from Oct. 15 through Dec. 7.

Special Enrollment Period (SEP) – certain life events can lead to an individual being eligible for enrolling in Original Medicare or enrolling in or changing Medicare health plans and/or drug coverage.  This election period goes on all year. Some examples of a Special Enrollment Period include:

  • Moving to a new location where new plan options are available

  • Losing employer coverage (Retiring, being laid off, etc)

  • Being diagnosed with a qualifying chronic condition, such as diabetes or chronic heart failure

  • Moving in or out of a skilled nursing facility or long-term care hospital

  • Gaining or losing MediCal

 

Medicare Advantage Open Enrollment Period (MA-OEP) runs from January 1st through March 31st. Beneficiaries who are currently enrolled in a Medicare Advantage plan can make a one-time change during this 3 month period.  They can either switch to a different Medicare Advantage plan or go back to Original Medicare and get a Prescription Drug plan.  If they want to add a Medicare Supplement plan, there is no guarantee that you will be approved; you’ll have to go through medical underwriting so be sure you give yourself time for approval before you leave your Advantage plan.

Remember that Independent Agents represent most of the carriers and don’t cost you any money to use them.  If you have any questions or need any help during this time, please feel free to reach out for help. We can be reached at (408) 848-2271 or email [email protected].  There is no cost for our services.